How much does Medicare pay for CPT 85060?

Medicare allowed an average of $23.02 per service and paid $18.16 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $84.59, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 85060?

Blood smear interpretation by physician with written report. It was billed 137,614 times to 123,939 Medicare beneficiaries by 2,623 providers in 2024.

Does 85060 pay differently in an office than a hospital?

Yes. The allowed amount averaged $22.65 in an office setting and $23.03 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 85060 most?

Pathology, with 133,586 services from 2,569 clinicians. Next are Clinical Laboratory, Hematology-Oncology, Hematology.

CPT 85060

Blood smear interpretation by physician with written report

$23.02Medicare-allowed amount per service, averaged across 137,614 services

Providers submitted

$84.59

Asking price, not received

Medicare allowed

$23.02

The fee schedule figure

Medicare paid

$18.16

Balance is patient coinsurance

Providers submitted an average of $84.59 for this code and Medicare allowed $23.02 — 3.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $18.16 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $22.65
Hospital / facility: $23.03

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 66 services were billed in an office setting and 137,548 in a facility.

Services: 137,614
Beneficiaries: 123,939
Providers billing it: 2,623
Total allowed: $3,167,874

What Medicare pays for CPT 85060

Across 137,614 services billed by 2,623 providers to 123,939 beneficiaries, Medicare allowed an average of $23.02 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 85060

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pathology	133,586	120,352	$23.03	2,569
Clinical Laboratory	3,095	2,767	$22.25	27
Hematology-Oncology	513	439	$25.53	18
Hematology	148	123	$23.13	3
Diagnostic Radiology	131	123	$21.70	2
General Practice	100	95	$23.33	1
Dermatology	19	18	$23.01	1
Medical Oncology	11	11	$22.57	1
Family Practice	11	11	$22.12	1

85060 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	16,184	$23.35	$18.14	237
Illinois	12,141	$24.08	$18.16	130
California	10,277	$24.55	$18.07	214
Ohio	9,183	$22.35	$18.01	144
Texas	8,825	$22.89	$18.09	193
Virginia	8,007	$22.52	$17.80	91
Pennsylvania	4,621	$23.17	$17.91	96
Michigan	4,511	$22.99	$18.01	102
North Carolina	4,128	$22.21	$17.90	67
Indiana	3,555	$21.99	$18.18	72
Colorado	3,039	$23.18	$18.09	62
Louisiana	2,936	$22.05	$17.89	42
Georgia	2,921	$22.65	$17.90	66
New York	2,833	$24.02	$18.02	88
Tennessee	2,799	$21.78	$17.73	58
South Carolina	2,751	$22.34	$18.00	43
Wisconsin	2,687	$22.13	$17.76	78
Missouri	2,538	$22.52	$18.04	61
Minnesota	2,477	$22.48	$17.91	80
Arizona	2,411	$22.58	$18.07	64
Maryland	2,149	$23.93	$18.05	54
Massachusetts	2,143	$23.97	$18.04	41
Connecticut	1,980	$24.09	$17.98	38
Washington	1,828	$24.25	$18.00	39
Arkansas	1,809	$21.81	$18.03	29
Iowa	1,781	$22.28	$18.09	37
New Jersey	1,754	$24.63	$18.09	41
Alabama	1,573	$21.87	$17.94	34
Kansas	1,569	$21.87	$18.10	32
Kentucky	1,403	$22.43	$17.71	38
Oklahoma	1,401	$21.89	$18.06	25
West Virginia	1,138	$22.63	$17.62	26
Mississippi	1,102	$21.81	$18.13	22
Nebraska	1,070	$21.55	$17.90	20
Nevada	736	$22.43	$18.23	21
South Dakota	728	$22.27	$17.43	10
Oregon	626	$23.11	$17.51	12
New Mexico	611	$22.34	$17.72	18
Utah	585	$22.30	$18.02	19
North Dakota	447	$22.46	$17.91	12
Maine	438	$22.59	$17.00	9
New Hampshire	372	$23.28	$17.89	6
Montana	333	$22.50	$18.16	7
Delaware	306	$22.81	$18.25	7
Idaho	280	$21.77	$17.43	12
District of Columbia	233	$24.83	$18.15	9
Rhode Island	126	$22.31	$18.24	2
Vermont	100	$22.56	$17.18	4
Alaska	72	$30.49	$18.20	5
Hawaii	62	$23.64	$17.99	4
Guam	23	$24.55	$17.46	1
Wyoming	12	$22.64	$16.74	1

Related codes

85025Complete blood cell count (red cells$7.59
85027Complete blood cell count (red cells$6.33
85045Red blood count$3.90
85018Blood count, hemoglobin$2.31
85014Red blood cell concentration measurement$2.31
85007Microscopic examination for white blood cells$3.71
85097Bone marrow, smear interpretation$51.39
85046Red blood count automated$5.44
85044Red blood count$4.21
85055Reticulated (young) platelet measurement$34.89
85048Automated white blood cell count$2.47
85049Platelet count$4.37

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.